Medicare, BCBS most favored payers among ambulatory care providers

Despite its reputation in the political arena, Medicare is a highly favored payer among ambulatory care providers, according to a report from medical research firm Peer60. Meanwhile, UnitedHealthcare has the most contracts with providers, but is the least liked of all payers examined.

For its report, Peer60 surveyed more than 790 ambulatory facility professionals who have a hand in payer-provider relations. The top 10 payers--as far as number of contracts--include: United, Blue Cross Blue Shield, Medicare, Aetna, Cigna, Medicaid, Humana, Tricare, Anthem and Coventry. These 10 payers hold 60 percent of all contracts with the surveyed ambulatory facilities.

What healthcare providers want most in a payer are fast reimbursement and contracts that don't dominate staff's time, according to Peer60. Medicare has the fastest reimbursement and least amount of paperwork required for ambulatory providers, per the survey, as well as denies the fewest claims.

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Overall, Blue Cross Blue Shield leads the payer brands as the most liked--in part because of Blues plans' ability to build relationships with providers, the report says.

Peer60 found Medicare's second-place ranking to be the most surprising, considering widespread assumptions that the government-run insurance provider is "slow, inefficient, broken and inflexible," the report notes. United's designation as the least-liked payer, though, is not especially surprising, as the more well-known and widely used an entity is, the more criticism will surface, according to Peer60.

Medicaid also raked in some accolades such as best pre-certification, lowest staff time required and easiest negotiations. Military-focused government healthcare program Tricare boasts the best customer service of all 10 payers examined in the survey.

To learn more:
- download the Peer60 report

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